Pathologists, the medical directors of most laboratories, obtain fundamental training in laboratory medicine during residency. The American Society for Clinical Pathology has provided the Residency In-service Examination (RISE) to pathology residency programs for over 20 years. The RISE is used as an assessment tool by every pathology residency program in the US, and examines clinical chemistry, cytopathology, forensic pathology, hematopathology, immunopathology, laboratory administration, microbiology, surgical pathology, transfusion medicine, and special topics (molecular pathology, cytogenetics, flow cytometry).
A retrospective comparison of mean scores in each RISE content area was undertaken to ascertain whether scores increase uniformly from the first to fifth years of residency training. Effective training in laboratory medicine should result in increasing scores in all RISE content areas.
For pathology residents completing training in years 1999 through 2004, the differences in mean scores between the first and fifth years were compared.
Although scores in all content areas increased from the first to fifth year of training, the increments varied: laboratory administration 47.3, clinical chemistry 48.5, forensics 59, microbiology 63, immunopathology 83.1, transfusion medicine 87.1, hematopathology 99.5, surgical pathology 102.3, cytopathology 106.1, and special topics 110.5. The increments in scores for laboratory administration, chemistry, forensic pathology and microbiology were all significantly lower than those for transfusion medicine, hematopathology, surgical pathology, cytopathology, and special topics (p<.05, student t-test).
The RISE content areas of laboratory administration and clinical chemistry have the lowest increments in scores over the 5 years of residency training. If improving quality in laboratory medicine depends on effective laboratory directors, more attention should be directed toward graduate medical education in laboratory administration and clinical chemistry.
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